Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Department of Midwifery and Reproductive Health, Nursing and Midwifery School, Mazandaran University of Medical Sciences, Sari, Iran.
Infection. 2017 Oct;45(5):589-600. doi: 10.1007/s15010-017-1031-2. Epub 2017 Jun 2.
Preeclampsia (PE) is one of the major causes of maternal and perinatal morbidity and mortality, especially in low- and middle-income countries. In recent years, a growing body of literatures suggests that infections by bacteria, viruses, and parasites and their related inflammations play an important role in the pathogenesis of PE.
We searched PubMed, Google scholar, and Cochrane databases using the following search words: "infection and preeclampsia," "bacterial infection and preeclampsia," "viral infection and preeclampsia" and "parasitic infection and preeclampsia."
The literature review revealed that many bacteria including Helicobacter pylori, Chlamydia pneumonia, and those are involved in periodontal disease or urinary tract infections (UTIs) and some viral agents such as Cytomegalovirus, herpes simplex virus type-2, human immunodeficiency virus, and some parasites especially Plasmodium spp. and Toxoplasma gondii can be effective in development of PE. Inflammation responses against infections has major role in the inducement of PE. The shift of immunological cytokine profile of Th2 toward Th1 and high levels of pro-inflammatory cytokines (TNF-ɑ, IL-12, IFN-γ, etc.), increase of oxidative stress, increase of anti-angiogenic proteins, increase of vascular endothelial growth factor receptor 1 (sVEGFR1), and complement C5a are the main potential mechanisms related to infections and enhanced development of PE.
Thus, early diagnosis and treatment of bacterial, viral, and parasitic infections could be an effective strategy to reduce the incidence of PE.
子痫前期（PE）是孕产妇和围生儿发病率和死亡率的主要原因之一，尤其在中低收入国家。近年来，越来越多的文献表明，细菌、病毒和寄生虫感染及其相关炎症在 PE 的发病机制中起重要作用。
我们使用以下搜索词在 PubMed、Google Scholar 和 Cochrane 数据库中进行检索：“感染与子痫前期”、“细菌感染与子痫前期”、“病毒感染与子痫前期”和“寄生虫感染与子痫前期”。
文献复习表明，许多细菌，包括幽门螺杆菌、肺炎衣原体和那些与牙周病或尿路感染（UTIs）有关的细菌，以及一些病毒制剂，如巨细胞病毒、单纯疱疹病毒 2 型、人类免疫缺陷病毒和一些寄生虫，特别是疟原虫和弓形虫，都能有效引发 PE。针对感染的炎症反应在诱导 PE 中起主要作用。Th2 向 Th1 的免疫细胞因子谱转移以及促炎细胞因子（TNF-α、IL-12、IFN-γ 等）水平升高、氧化应激增加、抗血管生成蛋白增加、血管内皮生长因子受体 1（sVEGFR1）增加和补体 C5a 增加是与感染相关的主要潜在机制，并增强了 PE 的发展。
因此，早期诊断和治疗细菌、病毒和寄生虫感染可能是降低 PE 发病率的有效策略。
